10 things you should or should not do when you call an ambulance

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I have a website about EDs. The system won't allow me to show the URL because I don't have enough posts.

I am creating a list of do's and don'ts for the site. Depending on how the content fleshes out, it will be something like "10 things you should or should not do when you call an ambulance". Would anyone like to contribute any suggestions?
 
Thanks a lot for the links, Dr Parasite. I'm hoping that some members will provide personal comments about does don'ts, too.
 
Do call me when you need me.
Do need me when you call me.
Don't make me side step five cars and able bodied drivers while I'm stair chairing you out because your back hurts.
Don't tell me to wait while you pack a bag, feed the fish, load the dishwasher and call five people before we go to the hospital.
Do tell me what's wrong.
Don't start at 1976.
Do tell me what meds you take.
Don't tell me you took them when you didn't.
Do tell me what I can do to make you feel better.
Don't be an ahole about it.
 
Can you tell us what the purpose of your site is?
 
The site is for people going to EDs, and their friends and relatives. It includes resources, such as current wait times for specific EDs and videos and printable fact sheets that explain specific conditions. It is divided into the following three main sections:

Getting to the ED
Should you call an ambulance? Should you ask a friend for a ride? Should you even go at all? ...

At the ED
What can you do to help make the admission process quick and efficient? How long will you have to wait? Who gets served first? ...

After the ED
How should you treat your condition after being discharged from the emergency department? Should you be taking any medication and, if so, for how long?...
 
OP, while I applaud your efforts with educating the layperson as to how, and what to expect with an emergency department "experience" I fail to see how this is a new, or fresh idea, let alone something many ED's throughout the country aren't already offering.

@hometownmedic5 gave some brutally honest answers that accurately depicts how many people on this end of the prehospital/ emergency spectrum view things. I highly doubt that's something most people visiting your site would want to hear. Anyhow, best of luck and perhaps others on here will offer up some suggestions to help you out.
 
You're right VentMonkey. Similar sites already exist online. I'm just trying to create one that's more useful and up to date.

Thanks for your help everyone. I look forward to more suggestions.
 
Don't call 911 thinking you'll be seen faster at the hospital. You won't. The hospital will triage you just the same as if you walked in the public entrance, which means even if you show up via ambulance the ER may have you wait in the waiting room (same as if you drove yourself or got a ride), or as a lot of our local hospitals like to do, will keep you on the ambulance gurney while you wait in line for a bed, and you can watch patients from the waiting room be brought in before you......my record for waiting on a bed is 8 hours because the hospital simply had no room (they said there were like 50+ people in the waiting room already) and was unwilling to have our patient go into the waiting room. So No, going to the hospital via 911 ambulance will not get you seen any faster if you don't have an actual emergency condition.

Calling 911 if you have knee pain after you got into an accident on your motorcycle is perfectly fine....less if it's 24 hours later. Ok, if the pain got worse to the point where you couldn't stand/walk on it sure....but if you drove yourself home after the accident because you wanted to watch the game instead, and only called because a family member said you should go to the hospital because it's still sore 24 hours later and you can stand and walk without any difficulty, well that's not exactly an emergency.

Don't call 911 and demand we take you to your hospital 20 miles away the would drive by 3 closer hospitals. Note I said "Demand" not "Ask". It's ok to ask. If we think you're sick enough that you might need to be admitted, and you're stable enough, it might be easier to just go to the further hospital. If you're not stable enough, we won't even entertain the thought, not unless the closer hospital is packed and doesn't have any ER space left (i.e. the hospital in my first note that was so slammed we waited 8 hours...). If you're not stable, we'll take you to the closest appropriate facility. Period. That usually means the closest...but if your condition requires a specialty center (i.e. serious life-threatening traumas, strokes, certain types of heart attacks, etc) we'll bypass the closest to go to the necessary specialty center. Otherwise, if you have a minor injury/condition that you'll be in and out of the ER in a few hours, there's no point in going past an open closer hospital.

(note, don't call 911 expecting us to take you to your doctor...unless your doctor is doing his/her rounds in the ER at that moment because we cannot take you anywhere else except the emergency room, we can't take you directly to your doctor's office unless you have your doctor pre-arrange a non-emergency pickup with the company first which wouldn't be a 911 call anymore).

So please, definitely don't be the guy who met all 3 of the above....hurt his knee in a motorcycle accident the night before, the pain was minor enough he rode home instead of the hospital because watching the game was more important to him, then was able to stand and walk around no problem as he had driven to work, worked, driven home in the evening no problem, and then only called because his daughter told him he should really go get checked out since his knee was still sore 24 hours later. He didn't want to wait hours to get seen, so he figured if he called 911 and went to the ER he'd be seen immediately....at his hospital 20 miles away passed 3 closer ones. Walked out of the apartment complex and met us out on the street curb, didn't want us to take him to any of the closer ones, seemed genuinely surprised that the emergency ambulance wanted to take him to the closest ER instead...and that he might still have to wait anyway. After being advised that no, we were going to go to the closer hospital and that he'd most likely have to wait even if he came in on our gurney, and even if we went straight to his preferred facility and got seen by a doctor immediately he'd still get a 4 figure bill from us for the transport....well, in that case, he'd rather just drive himself to his hospital, as the car on the curb he met us at happened to be his, and we felt no need to impede him as he climbed in his drivers seat instead of the back of the ambulance and drove off, and we were able to wave off the incoming fire company as patient left scene ha (though of course, we were on another call 20 min later I do believe lol)
 
Do know where you are, especially if you are calling by cellphone. Yes, newer cellphones should get your location accurately, but the system may not always work or may not exist at all if you have an older phone. Also, "somewhere on Main Street", "at my friends house", and "on a highway" are not good locations.

Do have someone direct the ambulance in, especially if you are calling from a large office building, factory, park, or any other location where it may not be immediately obvious where the patient is actually located inside the facility

Do notify security or building management of the call after you get off the phone with 911, especially if you work in a high-security facility. Also they may be able to help with reserving elevators, directing the ambulance etc, and may even have medical responders on staff

Do realize we are an EMERGENCY service and transport to ERs. We don't schedule pickups hours later, and don't transport to doctors offices, clinics, pharmacies, urgent cares or PT/OT offices. If you need transportation please look up the number to the non-emergency ambulance or gurney van service

Don't insist on ridiculous transport destinations, No, we are not going to take your middle or high schooler 70 miles away for a sprained ankle, even if you insist that they are a "lock" for the MLB/NBA/NFL etc, nor are we going to take you the same distance for general illness, even if "that's where your doctor is".

Don't wait to call with priority symptoms. Chest pains, stroke signs, difficulty breathing require an ambulance now, not later, and definitely not more than a day later
 
To expand upon a couple of other good points:
hometownmedic5 said:
Do tell me what meds you take.
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Yes, please also tell me which meds you're supposed to take but don't for whatever reason. And gather up your prescriptions, especially if you have a lot (I don't need 20 bottles of the same meds, but if you take 20 different meds, and don't have a comprehensive list you can give to me, having each of those 20 meds we can take is very helpful). And if you truly can't remember the names of the meds, it's fine to say the hospital has a list....but don't say that as an excuse not to tell me. You would be surprised at the number of patients I've had get an attitude with us "Why do you want to know that??!" like I'm only being nosy....you called me for a medical reason....I need to know your medical conditions, and that includes your medicines (and WHY you're taking them!*). Yes, the hospital might have a list....that doesn't help me out right now....Yes you told the firefighter 10 minutes ago, but guess what, the firefighter isn't the one taking you to the hospital, writing the chart, and having to give a handoff report to the nurse at the hospital (who's going to want to know without having to spend 20 min digging up your records on the computer..)
*It's always fun for someone to tell us their only medical history is high blood pressure, but yet they have 20 different prescriptions they're supposed to be taking....tell us why you're taking your meds, and all other diagnosed conditions or things you see a doctor for, yes your high blood pressure might be controlled by meds and at 120/80 but you still have a history of hypertension we should know about....


vc85 said:
Do have someone direct the ambulance in, especially if you are calling from a large office building, factory, park, or any other location where it may not be immediately obvious where the patient is actually located inside the facility
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Not just a large office park, but even your house on the street. All to often we're inching down the street trying to read the house numbers in the dark because you don't have a porch light on and the numbers painted on the curb are half flaked off (assuming no one is parked in front of it) and your house is otherwise indistinguishable from all the others so we have no idea where exactly we're going yet....so yes DO turn on the porch light and any other outside lights. DO have someone go outside to flag us down if possible. DO lock up any pets (we don't want to get attacked by your dog, or have your indoor cat decide to bolt and run down the street. Do open any gates/doors in the way, especially if you're in an apartment complex with locking gates, etc DON'T make me figure out how to squeeze my gurney past the 5 cars in your driveway...
 
Thanks for all of your excellent suggestions everyone. I might need to increase the list from 10 to 20 tips.

BTW, if you would like to broaden the topic to include other people, like doctors and nurses, please feel free. Although it might not be appropriate for this specific project, I will find a way to use the information eventually.
 
Initial comments:
"Think about it from the ambulance driver's point of view" the term, ambulance driver, is actually quite insulting to many, since many of us are either EMTs or Paramedics; we do a more than drive the ambulance (although in some systems, that's sometimes a stretch)

the first statement you should say is to allow the dispatcher to ask their questions, before anything else. the most important questions is to get the location of where you are calling from. everything else is moot if you don't get a good, clear accurate location (including apartment or floor number, or business name).

Also, the people who answer the phone when you call 911 aren't operators; this, too, is an incredibly insulting term. When you dial 0 on your phone, you speak to an operator. when you dial 911, you speak to a 911 telecommunicator, or 911 dispatcher. They also can't always location where you are, especially if you are calling from a cell phone. an old fashion POTS landline is the best way to ensure the 911 officer gets your address directly from the system, especially if you can't talk.

"Be ready to go. Don't waste time looking for a jacket or a purse." this is actually very bad advice. have someone find your purse and jacket while you are waiting for the ambulance; it's cold outside, and while the EMS crews will cover you with blankets, you will want to have a jacket for when you are discharged from the hospital. You will also need your purse, because it contains your insurance information, which the hospital will need. So while you shouldn't be looking for that stuff after the ambulance arrives, finding it prior is a good idea. The same goes for finding a list of the medications that you take on a regular basis.

"Don't argue about what hospital the ambulance will go to. The first responders will know the best option based on wait times, equipment available, and any other significant factors." This is both bad advice, incorrect, and flat out wrong. Any patient has the right to go to whatever hospital they chose, provided it is within the agency's service area, and it is capable of handling the patient. If you are insisting on going to a particular hospital, despite it having a 3 hour wait, you can go there. We don't always know what the wait times are. However, there are times when EMS will need to take you to a specialty center based on the condition you have (ie, if you get shot 3 times, taking you to the local community hospital is probably not in your best interests)
 
I would also add the following:
the ambulance IS NOT around the corner. even if there is a hospital or EMS station down the street, there is no guarantee that there is an available ambulance there. The might be on another call, helping another sick person, or simply unavailable. Please do not call 911 every 2 minutes asking where the ambulance is, or have several people in the house call 911 at the same time, as there are only so many 911 dispatchers available to handle all the calls. The average response time is around 10 minutes; so follow the directions that the 911 dispatcher gives you, as YOU might be able to help the person in need before the ambulance arrives.
 
DrParasite said:
Don't argue about what hospital the ambulance will go to. The first responders will know the best option based on wait times, equipment available, and any other significant factors." This is both bad advice, incorrect, and flat out wrong. Any patient has the right to go to whatever hospital they chose, provided it is within the agency's service area, and it is capable of handling the patient. If you are insisting on going to a particular hospital, despite it having a 3 hour wait, you can go there. We don't always know what the wait times are.
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This is not necessarily true for all systems. For a while in my system if a patient who we deemed was BLS wanted to go to a hospital that had extended bed delay times (I believe 30-90 minute range) we would flat out say no. The patient at that time has two options: 1. Go to a different ED or 2. Sign out AMA.

For my system if a hospital has extended bed delay times our dispatch will inform us when we start transporting so we can inform the patient.

There are still systems where if their coverage is low they go to the closest appropriate hospital reguardless of the patients wishes.
 
For my area a 3 hour bed delay means you're waiting on the ambulance gurney (with crew) for 3 hours. Our hospitals are loath to send even ambulatory BLS patients to the waiting room off our gurney (and some of the charge nurses practically take it as a personal insult, i.e. "how dare I tell them how to do their job?" If i start suggesting out patient is waiting room or fast track worthy). So if I know a certain hospital has a multi hour wait, yeah I'm going to strongly suggest we go somewhere else (especially on a busy day where system resources are already strained "holding the wall" instead of available covering).

So it seems like there's some advice that's be good for area X, but won't apply to area Y, and would be bad advice for area Z as everywhere has it's own approaches to END, including different challenges in different areas means while there's certainly some broad brush strikes that apply to all of us, it can be tough to write a comprehensive guide like this that would apply equally to all of our different systems.
 
Once again, thanks so much for all of your helpful advice, everyone. I have revised my list of suggestions. I welcome any additional feedback.
http://erfaqs.com/home/getting-to-the-er/how-to-call-an-ambulance/

Although my primary goal is to make this the best resource for people in the US and Canada, it will inevitably be seen by people in other countries. Considering the sensitivity of the subject, I don't want to risk confusion by referring to region-specific terms (i.e., 911 vs 119). Do you think that terms like "dispatcher" and "emergency medical responders" are OK?

I'm thinking of condensing this information to create an infographic, and/or poster, and/or fridge magnet. To do so effectively, I will probably need to eliminate about half of the words. Any editing suggestions would be welcome.
 
ERFAQs said:
I'm thinking of condensing this information to create an infographic, and/or poster, and/or fridge magnet. To do so effectively, I will probably need to eliminate about half of the words. Any editing suggestions would be welcome.
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Okay....who is your Target Audience?
 
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